Doctors are able to sharply shrink the size of benign breast tumors by using a small probe that freezes abnormal breast cells.
The procedure, called cryotherapy, combines ultrasound and the probe in a type of image-guided therapy that is a painless, quick and noninvasive alternative to surgery, says Dr. Peter J. Littrup, a radiologist at wayne State University and director of the image-guided therapy program at Karmanos Cancer Institute, both in Detroit.
“We can treat major tumors on an outpatient basis with minimum discomfort. It is a great boon for patients and patient care," says Littrup, who performed the procedure in 27 women, reducing the size of their noncancerous tumors by an average of 73%.
Benign breast lumps affect approximately 10% of women, most in their late teens and early 20s, and they are twice as common in African-American women as Caucasian women, Littrup says. Although most lumps aren't removed, approximately one million are excised annually because of their size, continued growth or for cosmetic reasons, he says.
Cryotherapy is currently used to treat cancerous tumors in the prostate, Littrup says. He is also involved in trials using the procedure to remove malignant tumors in the lung and kidney.
LETHAL ICE
To perform the procedure, doctors will first numb the area around the tumor which is visible through ultrasound.
Next, they insert a cryoprobe—similar to a large needle—into the middle of the lesion and inject liquid nitrogen into it.
An ice ball forms at the tip of the probe and continues to grow until the ultrasound confirms the entire lump has been engulfed, killing the tissue around the tumor, Littrup says.
The benefits of the procedure, according to Littrup, arc that the ice is easily visible in the ultrasound so doctors can be precise in seeing the tumor, the method is painless and it doesn't affect the collagen in the breast, so it keeps its shape. Also, there is no significant scarring.
Insurers don't automatically pay for the procedure for benign lumps. "It depends on the insurers," Littrup says. But because the patients don't have to stay overnight, the procedure is cost effective, he says.
ANOTHER VIEW
Dr. George Hermann, a radiologist at Mount Sinai Medical Center in New York City, says the procedure is interesting, but he questions its use for benign breast lumps.
He says that physicians still need to do a biopsy, and then decide whether to remove any benign lumps.
Further, he says, if cryotherapy is used to remove a cancerous tumor, it's impossible to evaluate the mass afterward because it's gone. When a lump is surgically removed, you can study it, which is important to treatment, Hermann says.
But Littrup says cryotherapy has already been shown to be effective as a way to treat cancerous tumors (such as in the prostate) without surgical intervention.
